The stutterer when he is alone, in the privacy of his room and therefore not subject to any judgment of others, do not ever stutters. And ‘the impact with each other that triggers a whole series of negative ideas that affect the emotional and behavioral. By an underlying sense of worthlessness, it triggers a dreaded external judgment and proceed with a control word, irrational idea of being able to better manage the situation. Wrong cognitive elements that once learned can persist into adulthood negatively affecting the normal verbal fluency. The Integrated Approach Dr. Bitetti is an innovative treatment of the subject suffering from stuttering, both in children than in adults. This therapeutic model goes to have a positive impact not only on the peripheral part of the problem, depolarizing the control, but especially on the way of thinking of the stutterer. In this book, the stuttering is discussed from the point of view of cognitive, emotional and relationship, keeping in mind the trend of the stutterer to keep repressed its internal energy, which then becomes the block, not in the interior, but also in the word .

“A few days ago I had in my hands the last book of my friend psychologist Dr. Anthony Bitetti, entitled” Stammering THE INTEGRATED APPROACH “(IEB Publisher – October 2010).

I started reading it almost unwillingly. I am a child neuropsychiatry, concerned for training and for the type of daily activity, especially in very young children with epilepsy or developmental disorders.

Rarely happen to visit children with stuttering; I have always been convinced that the disorder has not organic but is a functional disorder, a kind of neurosis or psychosomatic disorder, often transient in preschool: I limit myself in these cases, especially to reassure the child and parents, and they suggest some simple rules hygiene of communication, I have always avoided the requirement of direct intervention on the language, that is, the use of speech therapy, and, in older children (and especially to the families of these children) have suggested an indirect approach to psychological type.

As I continued to read the book, very well written, I found myself moved by the personal story of the author (former stutterer) by the stories of his patients of various ages and from reconstruction, very reliable, the story of Demosthenes.

I had the further confirmation of the non-organic nature of the disorder and the futility (indeed the danger) of direct interventions on symptom confirming a sort of rule of thumb approach of the child psychiatrist affirmed by my late master Marcello Mario Pierro (“I believe that any form of rehabilitative intervention is basically indirect, as in fact acting on the interactions within an ecosystem”).

Stuttering, as is clear also from reading this book, is a disorder of the report, a psychological impediment to the growth of the subject, in severe cases can become a block of its development. The intervention then it can not be on the symptom but must be more profound: it is necessary that the subject suffers from stuttering reappropriate the skills often mortified, rediscovers his good resources, exceeds the phase of deep pessimism and able to reorganize the thought that in these subjects, which often limit ourselves to observe only the symptom of verbal disfluency, is unexpectedly and profoundly disorganized, as evidenced by the interesting examples given in this book. “